Polycystic Ovarian Syndrome: A Leading Cause of Female Infertility

Abstract

In India, infertility has traditionally been linked to women; though, interestingly, infertility impacts both genders almost equally. The aim of the current study is to explore Polycystic Ovary Syndrome (PCOS) as a significant contributor to female infertility, focusing on its clinical characteristics, associated risk factors, diagnostic standards, and contemporary treatment approaches. There are several reasons for female infertility, which include ovulatory dysfunction, endometriosis, reproductive tract infections, diminished ovarian reserve, lifestyle factors and exposure to endocrine-disrupting chemicals, and environmental pollutants. PCOS is the prime cause of infertility due to anovulation in reproductive-age women, affecting more than one in ten women (~11–13%) worldwide. Among women with a PCOS diagnosis, it is estimated that 70% to 80% individuals face infertility problems. Women with PCOS show a combination of three clinical features. irregular or missing ovulation, high androgen (male hormone) levels, and polycystic ovaries. Although PCOS is mainly recognized for affecting female fertility, it also has additional metabolic and psychological side effects. These include insulin resistance, dyslipidemia, endometrial cancer, and eating and mood disorders, including anxiety and depression. Timely detection and treatment of PCOS are crucial for lowering reproductive health threats. Clinical diagnosis usually adheres to the Rotterdam Criteria, requiring at least two of three diagnostic criteria to be present in adult women, namely hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. There has been no one-size-fits-all treatment for PCOS. However, modern PCOS management has evolved from merely controlling symptoms to a precision medicine approach that addresses multisystem symptoms, incorporating three essential therapeutic strategies: structured metabolic rehabilitation, pharmacotherapy for hyperandrogenism/insulin resistance, and assisted reproductive technologies. In conclusion, PCOS represents a significant factor in female infertility, linked to various reproductive and metabolic issues. Timely identification and a comprehensive, personalized treatment strategy are crucial for enhancing reproductive quality.